Health Department and Harvard Study Shows Increase in Preterm Births among Latina Women in New York City Associated With 2016 Presidential Election

Severe stressors, including economic and social threats and interpersonal violence, can lead to preterm births

The study is the first to look at the impact of the most recent U.S. presidential campaign and election on preterm birth rates

October 17, 2018 – The Health Department and the Harvard T. H. Chan School of Public Health today published Severe Sociopolitical Stressors and Preterm Births in New York City, a study showing that the 2016 presidential campaign and election may be associated with a significant increase in preterm birth rates among Latinas in New York City. The study was published in the Journal of Epidemiology and Community Health. A preterm birth, also known as a premature birth, is when a baby is born before 37 weeks of a pregnancy. Factors such as stress can lead to preterm births, and preterm birth increases the risk of infant mortality. The study was conducted using birth certificates of all singleton births that occurred in New York City from September 1, 2015 to August 31, 2017. Self-report data from the certificates on maternal race, ancestry and nativity was used to classify mothers in relation to being at risk of anti-immigrant, anti-Latino and anti-Muslim discrimination.

During the period before the U.S. presidential nomination (September 1, 2015 to July 31, 2016) and after the inauguration (January 1 to August 31, 2017), the New York City preterm birth rate increased from 7.0 percent to 7.3 percent. No change occurred among U.S.-born women, but rates rose among foreign-born mothers, from 6.7 percent to 7.0 percent. The biggest increase occurred among foreign-born Latina women, especially those born in Mexico and Central America, whose rates rose from 7.3 percent to 8.4 percent. The rise among women from the Middle East/North Africa and from travel ban countries was smaller. Rates did not change among White women or Black women. However, Black women had the highest rate of preterm birth at 10.3 percent. These results suggest that the increase in sociopolitical stressors and hate crimes tied to the 2016 presidential election may have contributed to the risk of preterm birth among targeted populations.

“This analysis highlights how the stress caused by racism and discrimination may induce preterm births, which are extremely harmful to both mothers and babies,” said Acting Commissioner Dr. Oxiris Barbot. “Every woman in this city has the right to have a healthy pregnancy and delivery regardless of their race or immigration status. The Health Department is committed to providing support and services to all mothers and their children to ensure that they live long and healthy lives.”

“The study results point to the importance of monitoring the health impacts of severe sociopolitical stressors and changing exposure to these stressors, as has occurred for groups targeted during the 2016 presidential election and its aftermath,” said Dr. Nancy Krieger, lead author on the study and Professor of Social Epidemiology at the Harvard T.H. Chan School of Public Health.

“Any increase in preterm birth rates is a cause for concern. New York City is already struggling with hugely disproportionate rates of maternal mortality and morbidity between white and black women, said Council Member Helen Rosenthal (Chair, Committee on Women).“As a city, we must intensify and expand our efforts to provide the necessary support and resources for expecting mothers before, during, and after birth, especially in our most vulnerable communities.”

In July 2018, First Lady Chirlane McCray and Dr. Herminia Palacio, Deputy Mayor for Health and Human Services, announced the City’s first comprehensive plan to reduce maternal deaths and life threatening complications of childbirth among women of color. The five-year plan aims to eliminate disparities in maternal mortality among Black and White women and to reduce the number of severe maternal mortality events in the five boroughs by half. The City will invest $12.8 million over the next three years in the plan and funding will go towards four initiatives:

  1. Creating a city-wide Maternal Hospital Quality Improvement Network
  2. Creating comprehensive maternity care at NYC Health + Hospitals
  3. Enhancing data quality and timeliness
  4. Launching public awareness campaign on pregnancy-related health risks, in partnership with community-based organizations and residents

The Health Department is committed to advancing health equity and providing valuable health services to New York City’s vulnerable populations through its initiatives:

Nurse-Family Partnership

Nurse-Family Partnership is an evidenced-based, nurse home-visiting program for high-need communities. Under the Nurse-Family Partnership, nurses visit women in their homes every one to two weeks during pregnancy and throughout the child’s first two years of life, offering guidance on: breastfeeding; child development; parenting skills; pregnancy planning; preventive health practices; and strategies to attain economic self-sufficiency. More information about Nurse-Family Partnership.

Healthy Start Brooklyn

The Healthy Start Brooklyn initiative focuses on central and eastern Brooklyn, serving the neighborhoods of Brownsville, East New York, Bedford-Stuyvesant and Bushwick. Healthy Start Brooklyn provides home visiting as well as resources on breastfeeding, perinatal depression, developmental delays and home safety. The program works with the entire family by engaging fathers through the program Fathers Also Matter (FAM), which supports men as parents through referrals to job training and other services. Healthy Start Brooklyn also operates the By My Side support program, pairing doulas (trained childbirth assistants) with pregnant women. More information about Healthy Start Brooklyn.

Family Wellness Suites

Family Wellness Suites are dedicated spaces at the Neighborhood Health Action Centers to promote maternal wellbeing and family health. A key strategy of the Health Department’s Birth Equity Initiative, the Family Wellness Suite offer restorative spaces for parents to breastfeed, rest, exercise, and strengthen their social support networks, which are often missing in communities with poor birth outcomes and high infant mortality rates. Programs offered at the suites will include activities to support breastfeeding, risk-reducing behaviors during and after pregnancy and, healthier eating, as well as resources for referral to medical and social service providers and birthing centers. More information about the Neighborhood Action Centers.

Sexual and Reproductive Justice Community Engagement Group Birth Justice

Sexual and Reproductive Justice Community Engagement Group Birth Justice educates about pregnancy and birth using Sexual and Reproductive Justice Principles. Through identifying and training community members to become Birth Justice Defenders, the campaign seeks to provide individuals and their communities with the information, skills and support to navigate health institutions, enabling them to confidently self-advocate for respect and full bodily autonomy throughout the course of their pregnancy and afterward. In parallel, a group of provider allies will be engaged with the purpose of increasing knowledge and implementation of best practices for respectful care at birth among providers.

OneNYC

OneNYC: The Plan for a Strong and Just City has a goal to ensure that all New Yorkers live a long and healthy life. Premature mortality is closely tied to poverty, which, in New York City correlates with communities of color that have long undergone structural and historical oppression. Under the OneNYC plan, the City has committed to reducing the premature mortality rate by 25 percent by 2040.

Center for Health Equity

The Center for Health Equity (CHE) works toward a fair and healthy New York where all residents – regardless of their zip code – have the opportunity to lead their healthiest lives. As a division of the Health Department, CHE strengthens the agency’s goal to eliminate health inequities for residents in neighborhoods impacted by racism and long-term disinvestment by organizations and institutions. CHE uses data and storytelling to highlight injustices, influence policy, and implement neighborhood-based strategies to foster health. More information about the Center for Health Equity.

Take Care New York

Launched in 2015, Take Care New York 2020 (PDF) is the City’s blueprint for giving every New Yorker the chance to live a healthier life. Its goal is twofold — to improve every community’s health and to make greater strides in groups with the worst health outcomes, so that the city becomes a more equitable place for everyone. TCNY 2020 aims to promote healthy childhoods, create healthier neighborhoods, support healthy living, and increase access for quality care. More information about Take Care New York.

Harvard T.H. Chan School of Public Health

Harvard T.H. Chan School of Public Health brings together dedicated experts from many disciplines to educate new generations of global health leaders and produce powerful ideas that improve the lives and health of people everywhere. As a community of leading scientists, educators, and students, we work together to take innovative ideas from the laboratory to people’s lives—not only making scientific breakthroughs, but also working to change individual behaviors, public policies, and health care practices. Each year, more than 400 faculty members at Harvard Chan School teach 1,000-plus full-time students from around the world and train thousands more through online and executive education courses. Founded in 1913 as the Harvard-MIT School of Health Officers, the School is recognized as America’s oldest professional training program in public health.

Article Citation

Krieger N, Huynh M, Li W, Waterman PD, Van Wye G. Severe sociopolitical stressors and preterm births in New York City: September 1, 2015-August 31, 2017. Journal of Epidemiology and Community Health 2018 Oct 17;

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MEDIA CONTACTS:

Health Department: Christopher Miller/Danielle De Souza, (347) 396-4177
PressOffice@health.nyc.gov

Harvard T.H. Chan School of Public Health: Christopher Sweeney, o: (617) 432-8416 | c: (617) 549-2638 csweeney@hsph.harvard.edu